Endoscopic procedures in hepatology: Current trends and new developments

Laleman, Wim; Vanderschueren, Emma; Mehdi, Zain Seyad; Wiest, Reiner; Cardenas, Andres; Trebicka, Jonel

doi:10.1016/j.jhep.2023.08.032

Cited by 9 publications

(11 citation statements)

References 129 publications

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“…Although HVPG is the gold standard method for measuring portal pressure, the difficulties in its practical application limit its use. 2 Other disadvantages of HVPG include its inability to evaluate presinusoidal and prehepatic PHT and its indirect, rather than direct, representation of portal vein (PV) pressures. 8 , 11 Since the gastrointestinal tract, the site of application of EUS, is a close neighbor of the portal circulation, the use of EUS in PV catheterization allows efficient observation of the area of interest and greatly facilitates PV application.…”

Section: Clinical and Research Consequencesmentioning

confidence: 99%

“… 9 , 13 The application of EUS for transgastric puncture of the portal vein has provided a minimally invasive alternative for practitioners previously confined to surgical or Transhepatic Intravenous Portosystemic Shunting options. 2 Poor prognosis is suspected in the presence of malignant portal vein thrombosis, and therefore FNA confirmation is required to differentiate between benign and malignant thrombus. One of the most important considerations during the evaluation of portal vein thrombosis in cirrhotic patients is to determine whether the thrombosis is of malignant origin when hepatocellular carcinoma (HCC) is suspected.…”

Section: Clinical and Research Consequencesmentioning

confidence: 99%

“…The contrast agents used for these methods consist of microbubbles that work by trapping perfluorobutane or sulfur hexafluoride substances in a lipid shell. 2 , 24 The principles of using these microbubbles are based on the liver’s blood supply system, which consists of 3 phases: arterial phase, portal venous phase, and late phase until the contrast agents are cleared. 9 , 25 In a study by Oh D et al 26 , it was shown that only 73.3% of patients with metastases could be detected with conventional EUS, while a very high success rate of 93.3% was achieved when contrast-enhanced EUS methods were used.…”

Section: Clinical and Research Consequencesmentioning

confidence: 99%

“…If data increases to show that EUS-SWE results are similar to or better than VCTE, EUS-SWE will become an indispensable tool in chronic liver diseases. 2 …”

Section: Clinical and Research Consequencesmentioning

confidence: 99%

“…With the new techniques and possibilities developed in the field of endoscopy becoming available in hepatologic approaches, the concept we call “endohepatology or endo-hepatology” began to resonate in the medical world. 1 , 2 In this article, we elucidate the usage areas of diagnostic endoscopic ultrasound (EUS) in endo-hepatology.…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic Ultrasonography In Diagnostic Endohepatology: The Hepatologist’s Swiss Army Knife

Albayrak

2024

The Eurasian Journal of Medicine

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In recent years, significant advances have been made in endoscopic ultrasonography (EUS) processors, transducers, and the instruments used. In parallel with these developments, the importance of EUS in the diagnosis, treatment, and management of chronic liver diseases has increased considerably. One of the most important advantages of EUS is that the ultrasound probe can examine the liver area under examination from a very close distance. Additionally, EUS provides the ability to provide excellent spatial files and real-time images; Doppler, elastography, and contrast methods are also widely used to increase diagnostic accuracy in EUS evaluations. Endoscopic ultrasound-guided procedures are an alternative method used when percutaneous approaches are not feasible. Endoscopic ultrasound-based advanced applications such as EUS-guided liver biopsy (LB), EUS-guided ascites assessment, the use of EUS in the evaluation of focal lesions of the liver, and EUS portal pressure gradient (EUS-PPG) measurements are becoming increasingly common and important. As a result of the developments in EUS devices and instruments, it is possible to perform all diagnostic procedures in hepatology with EUS. In other words, EUS can provide all the imaging and interventional procedures that a hepatologist would require for diagnosis in a single session, without the need for any other expertise other than the gastroenterologist (such as a radiologist, interventional radiologist, or surgeon). This is called the single-procedure diagnostic approach, or “all in one” in hepatology. From a hepatologist’s perspective, EUS can be thought of as the “hepatologist’s Swiss army knife.”

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Section: Clinical and Research Consequencesmentioning

confidence: 99%

Section: Clinical and Research Consequencesmentioning

confidence: 99%

Section: Clinical and Research Consequencesmentioning

confidence: 99%

“…If data increases to show that EUS-SWE results are similar to or better than VCTE, EUS-SWE will become an indispensable tool in chronic liver diseases. 2 …”

Section: Clinical and Research Consequencesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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